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General NPI Number Information
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NPI Number | 1710203971
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Entity Type | Individual
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Provider Name | ZACHARY JEFFERSON LINER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 1340 BROAD AVE STE 440
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City | GULFPORT
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State | MS
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Zip | 39501-2460
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Country | US
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Telephone | 228-867-4855
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Fax | 228-867-4870
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Provider Business Mailing Address
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Address Line | PO BOX 2668
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City | HAMMOND
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State | LA
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Zip | 70404-2668
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Country | US
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Telephone | 985-230-6700
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Fax | 985-230-1528
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 305178
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 305178
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 305178
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License Number State | LA
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